Κυριακή 12 Σεπτεμβρίου 2021

Functional endoscopic sinus surgery in a patient with cystic fibrosis after lung transplantation

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Vestn Otorinolaringol. 2021;86(4):73-78. doi: 10.17116/otorino20218604173.

ABSTRACT

Cystic fibrosis is genetic multisystem disorder with a predominant lesion of the respiratory tract. The duration and quality of life of these patients depends on the state of respiratory function. Progressive lung dysfunction is still the leading cause of mortality patients with cystic fibrosis. End-stage lung diseases in patients with cystic fibrosis, lung transplantation is a viable method of treatment. It has the ability to prolong life of these patients. Survival in cystic fibrosis has steadily increased medical treatment and post-transplant. Chronic rhinosinusitis (with nasal polys and without) impacts almost all cystic fibrosis patients, leading to significant reductions in quality of life. Chronic rhinosinusitis with nasal polyps is prevalent in the cystic fibrosis patients, and it is often a recalcitrant infection with multidrug resistant organi sms. Medical therapies such as nasal irrigations, nasal steroids, and antibiotics are critical for managing symptoms, but functional endoscopic sinus surgery is necessary for refractory cases. The unified airway hypothesis suggests that sanitation bacterial infection in the upper airway can also decrease bacterial burden in the lungs. The article presents a clinical case of successful endoscopic sinus surgery in a 15-year-old patient with chronic rhinosinusitis with nasal polyps and cystic fibrosis after lung transplantation. The intervention was performed under General anesthesia and controlled hypotension. Bilateral antrostomy, ethmoidectomy and Draf IIb frontal sinusotomy were performed by endoscopic endonasal approach. There were no intra - and post-operative rhinosurgical or lung complications. The follow-up period was 18 months. At present, there is no relapse of chronic polypous rhinosinusitis, and there are no indications for revision intervention.

PMID:34499452 | DOI:10.17116/otorino20218604173

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Infectious mononucleosis in practice of otorhinolaryngologist

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Vestn Otorinolaringol. 2021;86(4):79-85. doi: 10.17116/otorino20218604179.

ABSTRACT

Infectious mononucleosis (IM) is an acute viral infection that usually occurs with fever, acute tonsillitis, affects lymph nodes, liver, spleen, and with specific changes in the hemogram. One of the most frequent symptoms of the disease is sore throat which leads people to otorhinolaryngologist. Several pathogens may be the cause of IM, but Epstein-Barr virus(EBV) plays a key role. EBV is a γ-herpes virus and about 90% of world`s population is infected with this one. Severe IM can lead to potential life-threating conditions, for example upper airway obstruction, spleen rupture. In addition to acute IM, EBV-infection can lead to a number of neoplastic and autoimmune diseases. Due to the non-specificity of IM symptoms and the emerging difficulties in laboratory and serological diagnosis of this disease, the problem of timely diagnosis and treatment in th is category of patients remains very relevant.

PMID:34499453 | DOI:10.17116/otorino20218604179

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Hearing care aspects in universal face mask use during the COVID 19 pandemic

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Vestn Otorinolaringol. 2021;86(4):9-12. doi: 10.17116/otorino2021860419.

ABSTRACT

BACKGROUND: Typical cloth and medical masks, which are mandatory to wear during the COVID 19 pandemic, create visual barrier, obscure linguistic and nonverbal communication and interaction. Ski-slope hearing loss patients often don't admit their auditory insufficiency and do not use hearing aids due to acceptable speech intelligibility by using visual access to the mouth and other potential facial cues.

PURPOSE: To assess the impact of universal face medical masks in public places on motivation to using hearing aids of patients with ski-slope hearing loss.

PATIENTS AND METHODS: All the 504 patients (18-65 years old), who applied for < hearing care assistance and for the first time bought hearing aid were included. 266 patients (group A) applied from June to November 2020, when wearing facial masks was mandatory; 238 patients (group B) appli ed from June to November 2019, when wearing facial masks wasn't required. In both groups patients, who fulfilled the following criteria, were selected: 1) binaural mild to severe sensorineural ski-slope hearing loss lasting more than 3 years; 2) no progression of hearing loss within the last 3 years; 3) pure tone audiometry <20 dB HL at 125-1000 Hz frequencies; 4) hearing care with mono- or binaural hearing aids with the receiver-in-the-canal open-type. Questionnaires were administered to eligible patients in group A to assess the motivational components of acquiring hearing aids.

RESULTS AND DISCUSSION: In group A, 74 (28%) patients received hearing aids according to the inclusion criteria, and in group B, 46 (19%) patients received hearing aids (p=0.033). Significant factors determining hearing aid acquisition were lack of visual contact when wearing a mask, communication difficulties in noisy environments and lack of intelligibility in a concert hall or lecture.

CONCLUSION: Patients' motivation to hearing care grows in mandatory wearing facial masks conditions during the COVID-19 pandemic leading to an increase in patients using hearing aids.

PMID:34499440 | DOI:10.17116/otorino2021860419

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COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi

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Publication date: Available online 11 September 2021

Source: American Journal of Otolaryngology

Author(s): Ravi Meher, Vikram Wadhwa, Vikas Kumar, Daphylla, Junior, Raman Sharma, Ishwar Singh, P.K. Rathore, Ruchi Goyal, Ritu Arora, Sandeep Garg, Suresh Kumar, Jyoti Kumar, Munisha Agarwal, Meeta Singh, Nita Khurana, Tanu Sagar, Vikas Manchanda, Sonal Saxena

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Diagnostic and prognostic value of Beclin 1 expression in melanoma: a meta-analysis

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Autophagy plays a complicated role in the occurrence and development of cancer. Beclin 1 is a significant autophagy-related protein that plays an essential role in tumorigenesis, but its expression is controversial in melanoma. In this meta-analysis, we searched seven studies involving 638 melanoma patients. PubMed, Web o f Science, Google Scholar, Elsevier, and Chinese National Knowledge Infrastructure were used for literature retrieval. The I2 index was used to assess heterogeneity. The expression of Beclin 1 in the primary melanoma group was significantly lower than the non-tumor group tissues (P 0.05). Different expression intensities of Beclin 1 did not affect the overall survival and disease-free survival of melanoma patients. This study showed a trend of low expression of Beclin 1 in melanoma; patients with low expression of Beclin 1 were prone to the possibility of distant metastasis. The inconsistent profile of Beclin 1 expression in the prognosis of melanoma patients warrants further clinical investigation. Received 8 May 2021 Accepted 12 August 2021 Correspondence to Ping Huang, MD, Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, Hubei 430030, China, Tel: +86 15807192632; e-mail: huangping_hust@hotmail.com Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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Free vascularized fascia lata flap for total columella reconstruction

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Publication date: Available online 11 September 2021

Source: American Journal of Otolaryngology

Author(s): Rachel E. Aliotta, Joseph Meleca, Allison Vidimos, Michael A. Fritz

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A Novel Two Surgeons Approach to Bronchial Foreign Body Removal by Optical Instruments- An 11 Years Institutional Experience

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Abstract

A potentially life-threatening emergency in ENT practice is the aspiration of tracheobronchial foreign body. This commonly affects young children and requires early extraction. Successful removal provides immediate relief. However procedural complications can cause devastating morbidity like anoxic encephalopathy or instant death. The aim of this study is to describe the experience in our institution with two surgeons approach for removal of tracheobronchial foreign bodies by telescope and optical forceps. This is an observational study from the period of March 2010 to April 2021 in which 96 patients (59 males, 37 females; age range 3 months to 15 years) were diagnosed with foreign body aspiration. In all cases rigid bronchoscopy and FB removal under general anaesthesia was performed using the two surgeons technique. This technique was instituted once Storz make paediatric telescope (2.9 mm diameter 36 cm length), optical grasping forceps and optical suction were procured in March 2010. Aspirated material was inorganic or organic with varying location in right main bronchus, left main bronchus or the trachea. We highlight the OT setup, surgical algorithm and the advantages of this technique. Visual and tactile coordination between the two surgeons being the crux of this procedure; allows hands on mentoring of the next generation of budding surgeons in a real-life scenario without compromising patient safety.

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Effect of Efferent Stimulation on the Differential Sensitivity in Individuals with Normal Hearing

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Abstract

The aim of the article was to compare the conditions of silent and contralateral noise on Differential sensitivity in normal hearing individuals. A total of 40 participants (20 males and 20 females) were enrolled in the study with a mean age of 21.7 years, participants with normal hearing thresholds and no history of middle ear pathology were enrolled for the study. Difference limen tests such as difference limen for intensity (DLI), difference limen for frequency (DLF), and difference limen for time (DLT) were carried out in these 40 individuals in the two conditions of silent and contralateral noise using MATLAB. Statistical analysis was carried out using the SPSS version 25.0 were descriptive and inferential statistics were carried out. Data was normally distributed on the Shapiro–Wilk's test of normality due to which a paired t test was carried out to establish the nature of significance between the silent and contralateral noise condition. Results r eveal the presence of significant difference (P < 0.01) between the groups for DLF and DLT with contralateral noise condition performing better than silent condition for the parameters. However, no significant difference was obtained for DLI. There is a positive effect of the efferent auditory pathway on the Differential sensitivity thus implying that speech perception in noise is improved in the presence of background noise for normal hearing individuals due to this effect. But in case of DLI, the reduced spread of excitation could be the reason why there were no significant differences between silent and contralateral noise condition.

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Non‐invasive evaluation of subjective sensitive skin by transcriptomics using mRNA in skin surface lipids

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Abstract

Sensitive skin is a condition characterized by hypersensitivity to environmental stimuli, and its pathophysiology has not been fully elucidated. Questionnaires based on subjective symptoms, intervention tests, and measuring devices are used to diagnose sensitive skin; however, objective evaluation methods, including biomarkers, remain to be established. This study aimed to investigate the molecular profiles of self-reported sensitive skin, understand its pathophysiology, and explore its biomarkers. Here, we analyzed RNAs in skin surface lipids (SSL-RNAs), which can be obtained non-invasively by wiping the skin surface with an oil-blotting film, to compare the transcriptome profiles between questionnaire-based 'sensitive' (n = 11) and 'non-sensitive' (n = 10) skin participants. Exactly 417 differentially expressed genes in SSL-RNAs from individuals with sensitive skin were identified, of which C-C motif chemokine ligand 17 and interferon-γ pathways were elevated, while 50 olfactory receptor (OR) genes were downregulated. The expression of the detectable 101 OR genes was lower in individuals with sensitive skin compared to that in those with non-sensitive skin and was particularly associated with the subjective sensitivity among skin conditions. The receiver operating characteristic (ROC) curve demonstrated that the mean expression levels of OR genes in SSL-RNAs could discriminate subjective skin sensitivity with an area under the ROC curve of 0.836. SSL-RNA profiles suggest a mild inflammatory state in sensitive skin, and overall OR gene expression could be a potential indicator for sensitive skin.

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